Lymphoma Dr Rob Hicks Lymphomas are cancers that develop from cells of the lymphatic system.

In this article

What is lymphoma? Symptoms

Causes and risk factors Treatment and recovery

Advice and support

The lymphatic system helps to protect the body against infections and foreign material. There are two main groups of lymphoma - Hodgkin's and non-Hodgkin's - and within these, there are more than 30 different types.

There is no one single symptom that is unique to lymphoma or defines it – every person will have a different pattern of symptoms depending on several factors, including which parts of the body the lymphoma affects.

Many people do not feel unwell when their lymphoma is diagnosed. The cancer may be found by chance during a test or investigation for something else and so for some the diagnosis comes completely out of the blue.

Lymphomas often start in the lymph nodes or spleen. Lymphoma can spread to other parts of the lymphatic system and in the blood stream to almost any organ in the body. Certain types of lymphoma tend to affect particular tissues or organs.

Symptoms of non-Hodgkin's lymphoma and Hodgkin's lymphoma include:

• Painless swelling of lymph nodes in the neck, armpit or groin
• Fever or sweating, especially at night
• Weight loss
• Poor appetite
• Tiredness
• Persistent itching
• Abdominal swelling or pain
• Pain in the lymph nodes after drinking alcohol
• Cough or breathlessness

Non-Hodgkin's lymphoma makes up about four out of five lymphomas and is the fifth most common cancer in men and the seventh most common cancer in women in the UK. There are about 5,500 new cases in men and about 4,800 cases in women each year.

More than nine out of ten cases occur in adults and people who are diagnosed are usually over 50. It is twice as common now as it was 30 years ago.

Increasing age, some rare genetic diseases causing children to be born with an abnormal immune system, radiation exposure (for example, radiotherapy, nuclear accidents), regular chemical exposure (for example, to herbicides and insecticides) and reduced immunity increase the risk of developing non-Hodgkin's lymphoma.

Hodgkin's lymphoma makes up fewer than one in five cases of lymphoma in the UK, with about 1,500 new cases diagnosed every year. It's most common in people in their teens to 30s. Exposure to the Epstein-Barr virus (EBV) increases the risk of Hodgkin's lymphoma

Strengthening immunity and avoiding regular exposure to chemicals may help to reduce the risk of lymphoma.

Once lymphoma has been diagnosed the exact type of lymphoma must be determined in order to decide which treatment is most appropriate and consider what the prognosis is likely to be.

Several features are used to describe a lymphoma, including the appearance of the cells under the microscope, the patterns that form on the cells when they are stained in the laboratory with 'antibody stains', the presence of certain genetic abnormalities, and the type of symptoms that the lymphoma causes.

In most cases, Hodgkin's lymphoma can be cured. The main treatments are radiotherapy, chemotherapy, steroids, growth factors and intensive treatments with high-dose chemotherapy or radiotherapy in combination with bone marrow or stem cell transplant.

In the commonest types of Hodgkin’s lymphoma, for example, cure can be achieved in up to 90 per cent with the first efforts at treatment. Even in more advanced disease more aggressive or combined cancer therapies can bring similar cure rates.

Some types of lymphoma respond well to radiotherapy while some MALT or ‘mucosa-associated lymphoid tissue’ lymphomas of the stomach are thought to be caused by infection with the bacterium that causes stomach ulcers - Helicobacter pylori - and may shrink away just with antibiotic treatment.

The main treatments for non-Hodgkin's lymphoma are 'watch and wait' (this 'hands off' approach is used for low-grade lymphomas which grow very slowly) radiotherapy, chemotherapy, biological therapy, steroids, intensive chemotherapy or surgery.

Lymphoma Association

Helpline: 0808 808 5555
Website: www.lymphoma.org.uk

This article was last medically reviewed by Dr Trisha Macnair in March 2009.